Adverse effect of noise in the operating theatre on surgical-site infection

Department of Visceral Surgery and Medicine, University of Neuchâtel, Neuchâtel, Switzerland.
British Journal of Surgery (Impact Factor: 5.54). 07/2011; 98(7):1021-5. DOI: 10.1002/bjs.7496
Source: PubMed


The aim of this pilot study was to evaluate the noise level in an operating theatre as a possible surrogate marker for intraoperative behaviour, and to detect any correlation between sound level and subsequent surgical-site infection (SSI).
The sound level was measured during 35 elective open abdominal procedures. The noise intensity was registered digitally in decibels (dB) every second. A standard questionnaire was used to evaluate the behaviour of the surgical team during the operation. The primary outcome parameter was the SSI rate within 30 days of surgery.
The overall rate of SSI was six of 35 (17 per cent). Demographic parameters and duration of operation were not significantly different between patients with, or without SSI. The median sound level (43·5 (range 26·0-60·0) versus 25·0 (25·0-60·0) dB; P = 0·040) and median level above baseline (10·7 (0·6-33·3) versus 0·6 (0·5-10·8); P = 0·001) were significantly higher for patients who developed a SSI. The sound level was at least 4 dB above the median in 22·5 per cent of the peaks in patients with SSI compared with 10·7 per cent in those without (P = 0·029). Talking about non-surgery-related topics was associated with a significantly higher sound level (P = 0·024).
Intraoperative noise volume was associated with SSI. This may be due to a lack of concentration, or a stressful environment, and may therefore represent a surrogate parameter by which to assess the behaviour of a surgical team.

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Available from: Franziska Tschan, Nov 03, 2014
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    • "There are many publications on noise levels more generally in the OT. The World Health Organization (WHO) has recommended that noise levels in the OT should not exceed 30 dB (Concha-Barrientos et al. 2004), however the studies indicate that talk, instrument and machine noises, routinely exceed these recommendations for a safe working environment (Shapiro & Berland 1973, Posso 1982, Hodge & Thompson 1990, Lewis et al. 1990, Ray & Levinson 1992, Dodenhoff 1995, Murthy et al. 1995, Thompson & Kam 1995, Shankar et al. 2001, Love 2003, Nott & West 2003, Ullah et al. 2004, Singh & Trikha 2006, Beyea 2007, Kracht et al. 2007, Stringer et al. 2008, Tsiou et al. 2008, Barakate et al. 2010, Fritsch et al. 2010, Hasfeldt et al. 2010, Kurmann et al. 2011, Vouhe 2011, Chen et al. 2012, Ginsberg et al. 2013). Average noise level measurements have revealed that general OT noise reaches 65 dB, rising up to 74Á2 dB and higher when music is playing (Way et al. 2013). "
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    • "However, a recent study found a strong correlation between noise levels during the surgical procedure and the development of SSI. [9] Also, talking about non-surgery-related topics was associated with a significantly higher sound level. The authors conclude that intraoperative noise volume was associated with SSI and that this may be due to a lack of concentration, or a stressful environment, and may therefore represent a surrogate parameter by which to assess the behavior of a surgical team. "
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